Provider Demographics
NPI:1972065241
Name:ROGERS BEHAVIORAL HEALTH CALIFORNIA, INC
Entity Type:Organization
Organization Name:ROGERS BEHAVIORAL HEALTH CALIFORNIA, INC
Other - Org Name:ROGERS BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MSSW
Authorized Official - Phone:262-303-0580
Mailing Address - Street 1:34700 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-4500
Mailing Address - Country:US
Mailing Address - Phone:262-646-4411
Mailing Address - Fax:262-646-3158
Practice Address - Street 1:17140 BERNARDO CENTER DR STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2000
Practice Address - Country:US
Practice Address - Phone:833-783-7411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROGERS BEHAVIORAL HEALTH CALIFORNIA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-04
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)